关键词: 结核,肺, 老年人, 误诊, 疾病特征

Abstract:

In order to explore the reasons of misdiagnosis in elderly patients with pulmonary tuberculosis (PTB), this paper retrospectively analyzed the clinical data of 36 elderly PTB patients aged 60 years and above who were admitted to stay at Xiaogan Institute for TB Prevention and Control from October 2012 to September 2018 and received treatment. Of which 11 cases were misdiagnosed by the institute while the remaining 25 cases were misdiagnosed by the general hospitals before they came to the institute. Among those 36 elderly PTB cases, 4 cases with tuberculoma were misdiagnosed as peripheral lung cancer, 5 cases with bronchial tuberculosis were misdiagnosed as bronchial asthma, 4 cases with bronchial tuberculosis and atelectasis were misdiagnosed as central lung cancer, 1 case with bronchial tuberculosis and atelectasis was misdiagnosed as inflammatory atelectasis, 2 cases with hematogenous disseminated pulmonary tuberculosis were misdiagnosed as alveolar carcinoma, 5 cases with caseous pneumonia were misdiagnosed as lobar pneumonia, 3 cases with interstitial tuberculosis were misdiagnosed as interstitial pneumonia, 3 cases had pulmonary tuberculosis with fluid filling were misdiagnosed as pulmonary abscess, 4 cases had PTB with mass shadow and thick-walled irregular cavity were misdiagnosed as lung carcinoma, 5 cases with intractable tuberculous pleural effusion were misdiagnosed as malignant pleural effusion. Due to the atypical clinical features in elderly patients with pulmonary tuberculosis, it is very easy to be misdiagnosed, so clinicians should pay enough attentions to it.

Key words: Tuberculosis, pulmonary, Aged, Diagnostic errors, Disease attributes